This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Monday, December 19, 2011

Weekly Australian Health IT Links – 19th December, 2011.

Here are a few I have come across this week.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Clearly the big news this week has been the appointment of a new Federal Health Minister.

To date I have not heard of any comments from the new Minister on e-Health. If you spot some comments it would be useful for us all to know!

Under the covers we are seeing things starting to ease off a bit but we still see some new documents being released for the PCEHR.

Also we have interesting news from South Australia and their hospital systems this week and a range of smaller announcements - along will all sorts of security / privacy issues seeming to come out of nowhere!

OUTGOING health minister Nicola Roxon's elevation to top legal officer has a bitter sting in the tail for health consumer and privacy advocates she will take on "additional responsibility for Privacy and Freedom of Information".

Prime Minister Julia Gillard has, however, seen fit to remove cyber security policy from the new Attorney-General’s portfolio, while responsibility for national security research and innovation will move from the PM’s purview to Defence.

Ms Gillard’s cabinet reshuffle may allow the government to sidestep an embarrassing failure of Ms Roxon’s $500 million personally controlled e-health record system, due for launch next July 1.

With just six months to go, key specifications are undecided, key components – notably the National Authentication Service for Health transactions – are years from completion, while construction is yet to start on the core infrastructure.

NEW Health Minister Tanya Plibersek, already swamped with demands from GP, consumer, pharmacy and industry groups, has acknowledged the central role of general practice in Australian healthcare.

“Every Australian needs to be able to see a doctor at the right time in the right place when they need to [and we are] making sure that we have the workforce in place to do that [and] making sure that we've got the physical services located on the ground,” she said.

Yesterday’s cabinet reshuffle saw former Health Minister Nicola Roxon appointed Attorney General, the elevation of Mental Health Minister Mark Butler to Cabinet and the creation of a Disability Reform portfolio to be headed by Jenny Macklin.

GPs want to see drug interaction alerts in their clinical software more relevant to clinical practice, with better information on how severe an interaction could be, a survey has found.

A survey of more than 300 Australian GPs and pharmacists who were questioned about the drug interaction alerts they receive through their clinical software, revealed the majority want to see improvements in the system.

GPs want to see the alerts better presented, according to the survey, carried out by NPS and published in the MJA, (link) with the information formatted using headings with one or two succinct bullet points of information under each.

eHealth aims to improve the quality and safety of Australia's health system by introducing a more efficient way to collect and share information such as prescriptions and test results.1 The primary health care sector could benefit substantially from the widespread use of eHealth technologies.2 The National E-Health Transition Authority is currently working with numerous stakeholders, including GPs and allied health professionals to develop an eHealth uptake plan.2 This RESEARCH ROUNDup focuses on the use of eHealth technologies in primary health care, by exploring the benefits and current limitations of a number of eHealth tools.

Facebook is making it easier for people who express suicidal thoughts on the social networking site to get help.

A program launching on Tuesday enables users to instantly connect with a crisis counsellor through Facebook's "chat" messaging system.

The service is the latest tool from Facebook aimed at improving safety on its site, which has more than 800 million users. Earlier this year, Facebook announced changes to how users report bullying, offensive content and fake profiles.

The South Australian government is getting ready to roll out a $408 million state-wide e-health system to metropolitan hospitals and rural hospitals and services.

The Commonwealth Government has provided $90 million for the project under the Council of Australian Governments National Health Reform funding to improve elective surgery and emergency-department funding, with the South Australian government contributing $318 million over 10 years.

The product to be implemented for the project is from Allscripts Healthcare Solutions, which has previously completed large-scale roll-outs in the US, Canada and Singapore. Allscript's system will be installed in metropolitan hospitals and services, as well as at the Glenside Hospital, the new Royal Adelaide Hospital, South Australian Ambulance headquarters, GP Plus Health Care centres, GP Plus Super clinics, Mount Gambier Hospital and Port Augusta Hospital.

THE first step towards a paperless national health system in which patient records can be shared electronically has been taken.

A $408 million e-health program was launched in Adelaide yesterday.

While South Australia was busy rolling out its advanced e-health plan, other states were still planning their own different systems - raising doubts about a national strategy to ultimately link electronic records across all hospitals in every jurisdiction.

SOUTH Australian GPs will soon plug into a $408 million electronic record system that will provide real-time patient information, while experts have urged the rest of Australia’s GPs to prepare now for the national e-health rollout in July.

The enterprise patient administration system (EPAS) will see more than 3500 computers installed at bedsides in SA public hospitals, allowing doctors to access real time medical information about emergency patients, monitor progress of patients and exchange secure messages.

GPs with admitting rights to SA hospitals will have access to the new EPAS Clinician Portal, where they will be able to view patient information, test orders and medicines and review results.

Growing demand from an ageing population has prompted to Queensland Ambulance Service (QAS) to begin the search for a new ambulance transport request and scheduling system.

According to the agency, some 20,000 medically authorised non-urgent patient transfers are provided per month, and demand for these services is on the rise due to demographic and population health factors.

To help meet the data collection, resource utilisation, and reporting required to manage the demand for the transport service, QAS is now investigating available options.

THE cost of NSW Health's Oracle human resources information system has increased by almost $35 million and will not be complete until 2013, as a result of massive scope changes arising from the state’s restructure of health districts.

NSW Auditor-General Peter Achterstraat said the HRIS will now cost $94.3m and take two more years to address the extra configuration and development issues.

In January, the O’Farrell government established 15 local health districts to replace eight former area health services, to bring the state into line with National Health Reform arrangements.

Shortly after the report landed, Delimiter published an analysis of what the state should avoid doing next. Gershon-style reviews, super-chief information officers being flown in to take charge, focusing on shifting everything into IT shared services centres; analysts agreed that these sorts of quick fix solutions would just lead to more of the same problems that Victoria has already been experiencing.

With these obvious wrong turns out of the way, the focus today turns to some positive thinking. What are the steps which the Victorian State Government should be taking decisively forward at this point? Where can it look to for inspiration and a roadmap to better IT governance?

No matter which side of politics you support, and to the many in the “neither” camp, it is fair to say that the Federal government has had some unfortunate outcomes with the delivery and implementation of, what many see to have been, meritorious policies and ideas. The implementation of the pink bats and school halls schemes were marked by numerous controversies and, on occasions, subject to the processes of trial and error.

Most people seem to agree that the introduction of electronic health records (EHR) is both a good idea and good policy. People may argue about whether consumers should opt out rather than in, and its cost. But its stated objective of overcoming the fragmentation of health information, improving the availability and quality of health information, reducing the occurrence of adverse medical events and improving the coordination and quality of health care provided by different health care providers is difficult to criticise.

The U.K. Department of Health report “Whole System Demonstration Programme: Headline Findings—December 2011” said that early findings from the demonstration project involving 3,030 people with diabetes, heart failure or chronic obstructive pulmonary disease show that “if used correctly telehealth can deliver a 15% reduction in A&E (accident and emergency) visits, a 20% reduction in emergency admissions, a 14% reduction in elective admissions, a 14% reduction in bed days and an 8% reduction in tariff costs. More strikingly they also demonstrate a 45% reduction in mortality rates.” Authors also indicate that at least 3 million people with long-term conditions or social care needs could benefit from telehealth and telecare.

General Practitioners in the Blue Mountains West of Sydney will trial an e-discharge scheme that electronically notifies them when a patient is discharged from hospital.

The trial site is one of twelve locations around the country testing ehealth records standards and specifications ahead of the rollout of the PCEHR in 2012. The scheme is due to begin operating within the next few months.

Medicare Locals are to be given flexible funding arrangements that will allow them to channel savings from efficiencies and underspends into other areas, according to funding guidelines (link), released this week.

The new $1.5 billion funding system known as “Regionally Tailored Primary Health Care Initiatives through Medicare Locals Fund” will consolidate the 159 existing health and ageing programs into 18 larger, flexible funds from 1 July 2012, according to the blueprint released for consultation.

Welcome to another clinician e-newsletter brought to you by the Clinical Unit of the National E-Health Transition Authority (NEHTA) providing information on key issues and current events related to eHealth in Australia.

A CENTRELINK employee was sacked after accessing records belonging to customers and co-workers on 124 separate occasions, and misusing the agency's IT systems to benefit the people concerned.

The 26-year Centrelink veteran was terminated in early 2010, after an investigation into the many "unauthorised accesses” between January 2007 and January 2010.

The outcome is one of 14 cases of suspected breaches of the Australian Public Service code of conduct investigated by Centrelink over recent years; the heavily redacted findings have been published under Freedom of Information laws.

The lost property auction of more than 50 USB keys by RailCorp in Sydney has prompted an investigation by the NSW Privacy Commissioner into possible breaches of privacy laws around use and distribution of personal information.